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Medical Emergencies · single question

A diabetic patient with HbA1C of 9 has small periapical radiolucencies with no pain. What do you do?

  1. Refer to physician first
  2. Defer treatment indefinitely
  3. Can do simple extractions
  4. Prescribe antibiotics only and observe
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Correct answer: A. Refer to physician first

  • A. An HbA1C of 9 indicates POORLY CONTROLLED DIABETES (well-controlled = <7%). Before performing dental procedures on a poorly controlled diabetic, the dentist should REFER TO THE PHYSICIAN to optimize glycemic control. Poorly controlled diabetes impairs wound healing, increases infection risk, and can complicate dental extractions. Once the physician optimizes control, dental treatment can proceed.
  • B. Indefinitely deferring treatment abandons the patient — the appropriate action is to refer for glycemic optimization, then treat.
  • C. Extractions may be needed, but with an HbA1C of 9 (poorly controlled diabetes), the dentist should NOT simply proceed without medical consultation.
  • D. Antibiotics alone do not address the periapical pathology or the poorly controlled diabetes — physician referral is the appropriate first step.

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